MEDICARE: MECKLENBURG DIAGNOSTIC IMAGING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician		NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00315955	OTHER		MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	017M8	OTHER	NC	BCBS NC
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	153718702	OTHER	NC	DOL

General Provider Information

NPI Number	:	1962450155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MECKLENBURG DIAGNOSTIC IMAGING LLC

Provider Business Mailing Address
First Line	:	PO BOX 933393
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-0001
Country	:	US
Telephone Number	:	866-659-1211
Fax Number	:	336-774-1751

Provider Business Practice Location Address
First Line	:	1309 E SUNSET DR
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28112-4324
Country	:	US
Telephone Number	:	704-225-8674
Fax Number	:	704-225-7226

Authorized Official
Title or Position	:	COO
Name	:	MR. DANIEL J SCHAEFER
Credential	:
Telephone Number	:	770-300-0101

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	04/01/2009

Similar Medicare Providers

1184597304 — ARIANA L'HEUREUX
Practice Location Address:

1321 E SUNSET DR
MONROE, NC
28112-4324

Practice Phone: 704-248-6974
Practice Fax:

1780535617 — KIERRA DELAINE THOMAS
Practice Location Address:

1321 E SUNSET DR
MONROE, NC
28112-4324

Practice Phone: 704-248-6974
Practice Fax:

1932189545 — CAROLINA BONE & JOINT PA
Practice Location Address:

1315 E SUNSET DR
MONROE, NC
28112-4324

Practice Phone: 704-289-4595
Practice Fax: 704-289-5829

1972673283 — DR. JASON B MINSKY D.C.
Practice Location Address:

1309 E SUNSET DR
MONROE, NC
28112-4324

Practice Phone: 704-296-9090
Practice Fax: 704-296-9584

1861605024 — TAMMY MARIE ARROWOOD MS, PT
Practice Location Address:

1315 E SUNSET DR
MONROE, NC
28112-4324

Practice Phone: 704-289-4595
Practice Fax:

1982921318 — DR. NICHOLAS DANIEL-GRANT CHAPPEL D.C.
Practice Location Address:

1309 E SUNSET DR
MONROE, NC
28112-4324

Practice Phone: 704-296-9090
Practice Fax: 704-296-9584

Directions to “MECKLENBURG DIAGNOSTIC IMAGING LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.